| NPI | 1528449972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 59682) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA ACSW95682) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2015-06-16 |